Cambridge University Press has published a report detailing two medical students who developed vaccine-induced myocarditis after the first doses of the Pfizer-BioNTech COVID-19 shot.
The two patients “were young males with no previous medical history” and both had “their vaccine very recently before the event.”
The sixth-year medical students “with no known previous medical history complained about palpitations and chest pain during their night shift.”
“They had their first dose of BNT162b2 two and four days prior,” the report stated.
Cambridge University Press:
"Juice-Induced Myocarditis in Two Intern Doctors in the Same Night Shift"https://t.co/K5rqLWNVtj
— Marc Mongrain (@Lukathor) July 25, 2022
Cambridge University Press described these details from the two cases:
Case 1
A previously healthy, non-smoker, 23-years-old male complaining about palpitations that were on-going for 24-hours was presented to the emergency department (ED). He explained palpitations were episodic and worse when lying down. He denied any chest pain, shortness of breath, or any other related symptoms. He had no family history of cardiac disease. The patient received his first dose of BNT162b2 48-hours prior.
Patient’s vitals were as follows: arterial blood pressure: 112/80mmHg; heart rate: 112bpm; oxygen saturation: 98% on room air; and temperature: 36.6°C. Physical examination revealed no remarkable abnormalities. His electrocardiogram (ECG) showed global T-wave inversions, sinus tachycardia, and ST-segment elevations in V2-6, D1, D2, D3, and P-R segment depressions in precordial derivations (Figure 1). Point-of-care ultrasonography (POCUS) showed no pericardial fluid, no wall motion abnormalities, and no valvular defects with an ejection fraction (EF) of 60%.
His laboratory evaluation showed high-sensitive cardiac troponin T (hs-cTnT) levels elevated at 1.45ng/mL (normal range: 0.000-0.014ng/mL) and normal renal function tests. The patient was admitted to the coronary intensive care unit (ICU) for close monitoring and treatment with acute coronary syndrome and myocarditis pre-diagnoses. He was treated with Metoprolol and Ibuprofen. Twelve hours after admission, he started to complain about sharp, stabbing-like chest pain. Serial ECGs revealed no difference from the first one.
After three days of treatment, his hs-cTnT levels were down to 0.056ng/mL. He was discharged with Ibuprofen and Metoprolol. On discharge, the patient’s ECG had T-wave inversions in all precordial derivations.
Case 2
A previously healthy, 24-years-old male who was on the same night shift with Patient 1 and was admitted to the ED complaining about chest pain which he described as “squeezing” which was on-going for two days. His vital parameters were normal and he had no family history of cardiac disease. He received the first dose of BNT162b2 four days prior. Physical examination was normal. Patient 2’s ECG showed an incomplete right bundle branch block without any significant ST-segment changes (Figure 2). His blood panel revealed relatively lower but still high hs-cTnT as 0.065ng/mL and no other significant findings. His POCUS showed no abnormalities. This patient was also admitted to the coronary ICU for observation and further testing. He was discharged with full recovery after two days of observation and symptomatic treatment. His ECG remained the same throughout his stay and his final hs-cTnT value was 0.013ng/mL.
The paper proceeds to state the “risk of developing myocarditis after vaccination is very low.”
In the discussion, the paper suggests “that intravenous delivery of the vaccine might also be responsible for myocarditis.”
The conclusion reads:
A high vaccination rate is the only solution that is available today to eradicate SARS-CoV-2 and tackle the pandemic. Most of the time, vaccine-induced myocarditis is self-limiting and has a good prognosis. These cases also did not have ventricular dysfunction or long-term effects and healed within a few days. Considering the fact that morbidities after COVID-19 occur more than after the vaccine itself, vaccines are still the best option today.
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